 |
 |
 |
|
|
|
 |
 |
 |
 |
 |
 | |
|
VOLUME 4 Spring 2004 | ||||||
|
|
ADMISSIBILITY OF MEDICAL BILLS/EXPENSES AT TRIAL IN PENNSYLVANIA By Jennifer B. Hunter, Esq.
Before 2001, a plaintiff was entitled to recover the “reasonable value” of medical services rendered to a plaintiff. A jury could consider the full amount of medical expenses billed to a plaintiff, even if the plaintiff did not actually pay the entire amount of the bill. Since the 2001 Pennsylvania Supreme Court decision in Moorehead v. Crozer Chester Medical Center, a plaintiff is entitled to recover, as compensatory damages, only the amount actually paid and accepted by a health care provider and does not include medical expenses forgiven or written-off by the provider. Pennsylvania Courts now consider evidence of forgiven and written-off medical expenses to be inadmissible. Such evidence is irrelevant, prejudicial, and could serve to improperly inflate a jury’s damage award.
Because a plaintiff has a duty to mitigate damages, an insured plaintiff must submit medical bills to the insurance carrier. If medical bills are not submitted to an insurance carrier, the defendant must determine whether the plaintiff has health insurance before trial to address the issue of mitigation of damages.
The Pennsylvania Superior Court recently clarified the meaning of the Pennsylvania Motor Vehicle Financial Responsibility Act in Swords v. Harleysville Insurance. The Swords Court found that the owner of an uninsured registered vehicle is unable to recover first-party benefits such as medical benefits, income loss benefits, accidental death benefits, and funeral benefits.
The owner of a registered vehicle in Pennsylvania is obligated to carry minimum insurance coverage ($15,000/$30,000, including $5,000 in PIP) on the vehicle, even if it is a junk vehicle. If an owner fails to carry the statutory minimum, the owner is barred from recovering first-party benefits, even if he or she is injured as a passenger in an insured vehicle. A person who owns a registered vehicle may recover first-party benefits if properly insured. An individual who does not own a registered vehicle and does not hold insurance is still entitled to first-party benefits.
Section 1722 of the Pennsylvania Motor Financial Responsibility Act provides that a person is unable to board medical expenses that have been paid by a motor vehicle insurance policy or any other program, except an ERISA qualified program. Medical bills/expenses are inadmissible if “paid or payable” by an insurance company. However, a plaintiff may introduce the amount of a Medicare lien and/or Worker’s Compensation lien under the ERISA program exception. Therefore, medical bills/expenses are rarely admissible as evidence.
Juries typically use medical bills/expenses as indicators of the value of a case and the amount of damages to be awarded, and these limitations on the admissibility of medical expenses/bills benefits the defense. |
||
|
|
|||